• 한국콘텐츠학회논문지
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• 제10권1호
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• pp.325-333
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• 2010

여성의 자궁근종에 대한 유병률을 초음파진단장비로 확인하고 건강 관련 요인과 자궁근종과의 상관관계를 분석하여 건강 관련 요인이 자궁근종의 발생에 미치는 구체적인 발생 요인을 확인하고자 한다. 자궁근종이 진단된 모집단과 자궁근종이 없는 대조군을 대상으로 자가 기입식 설문조사를 실시한 결과 초음파진단 장비로 진단된 자궁근종의 유병률은 29.7%로 나타났으며, 자궁근종군의 연령분포는 40~49세가 41.4%로 가장 높게 나타났다(p<0.05). 자궁근종의 유병률에 영향을 미치는 각 요인에 대하여 조사한 결과, 연령, 결혼력, 직업의 활동량, 생활의 만족도, 체중, 비만도, 분만력, 수유, 유산, 피임 등은 자궁근종과의 상관관계에서 통계적으로 유의하였다.(p<0.05)

• 한국콘텐츠학회논문지
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• 제14권8호
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• pp.150-155
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• 2014

조직 건강성(organizational health)이란 조직의 기능수행능력이나 최적의 기능수행 상태를 나타낸다. 조직건강은 대인관계나 집단행동과 같은 조직학적 측면에서 뿐만 아니라 사회과학 전반에 걸쳐 중요하게 다루어져야 할 주제임에도 불구하고, 경찰조직을 대상으로 한 조직건강진단 지표 및 측정에 대한 연구는 전무한 실정이다. 따라서 이 연구에서는 결찰 조직건강 진단에 관한 시론으로 국내 외 문헌과 연구결과를 바탕으로 하여 조직이론에 나타난 조직건강에 관한 여러 학자들의 견해를 토대로 선행연구들의 분석을 통하여 조직건강의 개념, 측정지표를 설계하고자 하였다. 이 연구에서는 경찰조직 건강진단 지표를 조직행태(조직구조, 조직문화, 조직분위기, 환경적합성, 변혁적 리더십, 의사소통 및 의사결정방식), 집단행태(구성원 관리방식, 갈등관리방식, 집단결합력, 비전 및 전략, 공동체지향 및 책임공유), 개인행태(직무동기, 업무 관련요인, 신뢰, 활력, 조직냉소주의)로 구분하여 경찰 조직건강 진단지표를 설계하였다.

• 대한한의학회지
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• 제31권5호
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• pp.41-59
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• 2010

Objective: Headache is one of the most common symptoms in primary medical care. The purpose of this study was to support medical treatment by consideration of a new CTTH (chronic tension-type headache) oriental medical diagnosis index. Methods: An Oriental medical diagnosis questionnaire was administered to a CTTH group, migraine group and normal group. The result was classified by using LDA, CART, factor diagnosis and tested in comparison with the original diagnosis. Also, weighting method based on expert opinions was done. Results: 1. The result analyzed by using LDA has an accuracy of 93.9% in comparison with the original diagnosis. 2. High accuracy showed when the test was performed with about 35 significant questions and four questions selected based on SPSS Wilks' lambda. 3. There was accuracy of 90.9% when differentiation was performed by using CART compared with original diagnosis. 4. 10 factors has a high initial value after factor analysis, consisting of questions to the similar differentiation. 5. Diagnosis formula of headache was made by using weighting method based on expert opinions. Conclusion: Oriental medical diagnosis questionnaires make it possible to classify headaches significantly. The study about weighting method of CTTH can make it possible to classify symptoms more accurately.

• Journal of Oral Medicine and Pain
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• 제36권1호
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• pp.39-51
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• 2011

본 연구는 측두하악장애의 연구 진단 기준(Research Diagnostic Criteria for Temporomandibular Disorder; RDC/TMD)을 이용하여 구분된 측두하악장애(Temporomandibular Disorder; TMD) 환자를 대상으로 안면의 골격적 양상과 TMD 사이의 연관성을 규명하고 교정 환자의 진단과 치료에 있어 RDC/TMD의 활용 가능성을 제시하고자 하였다. 서울대학교 치과병원 구강내과에 측두하악장애의 진단과 치료를 위해 내원한 여성 환자들의 의무 기록 및 방사선사진을 검토하였으며 환자의 연령이 18세 미만이거나 전신 질환, 골격적 기형 또는 측두하악관절 부위의 외상 병력이 있는 경우는 제외되었다. 총 96명의 여성 환자로부터 얻은 RDC/TMD Axis I 을 포함한 임상 검사 결과와 측방 두부규격방사선사진 (lateral cephalogram), 파노라마 방사선사진(panoramic radiograph) 및 횡두개 방사선사진(transcranial radiograph)을 이용한 방사선적 검사 결과를 분석하였다. RDC/TMD를 이용하여 집단을 분류한 후 측방 두부규격방사선사진의 각도 및 길이 요소들을 계측하여 안면의 골격 관계, 상하악 관계 및 치열 관계를 분석하였다. 통계적 분석법으로는 독립표본 t-검정(independent t-test), 일원분산분석(one-way Analysis of Variance; one-way ANOVA) 및 카이제곱 검정(chi-square test)을 이용하였고 다음과 같은 결과를 얻었다. 1. 근육 문제를 진단하는 RDC/TMD Axis I 의 제 1 군 측두 두부방사선적 특징에서 통계적 유의성이 인정되지 않았다. 2. 관절원판 변위를 임상적으로 진단하는 제 2 군에서는 개구 장애를 동반하지 않는 비정복성 관절원판 변위가 있는 경우 관절원판 변위가 없는 정상 집단에 비하여 articular angle이 큰 것으로 나타났다. 3. 관절통, 관절염 및 관절증을 진단하는 제 3 군에서는 articular angle, FMA, Bjork sum, posterior facial height 및 facial height ratio에서 유의한 차이가 있는 것으로 분석되었다. 4. TMD 진단군과 골격적 양상 사이의 관계를 단순화하기 위하여 RDC/TMD Axis I 각 군을 양분법적으로 분류한 뒤 동일 한 방식으로 분석을 시행하였다. 그 결과 제 1 군에서는 overjet, 제 2 군에서는 articular angle, facial height ratio 및 IMPA, 마지막으로 제 3 군에서는 articular angle, gonial angle, facial convexity, FMA, Bjork sum, posterior facial height, facial height ratio 및 ANB angle에서 유의한 차이를 보였다. 이상의 RDC/TMD Axis I 을 이용하여 진단된 측두하악장애 환자를 대상으로 안면의 골격적 양상과 TMD 사이의 연관성 을 분석한 결과로부터 RDC/TMD Axis I 임상 진단에 따라 진단한 측두하악장애 환자 중 제 2 군과 제 3 군의 환자들에서 측두하악장애와 관련된 것으로 알려진 하악골의 후하방 회전으로 인한 골격적 차이가 존재함을 확인하였다. RDC/TMD Axis I은 교정 전 혹은 교정 치료 진행 중에 임상 검사 및 일반 방사선사진으로부터의 제한된 정보를 바탕으로 교정 치료 중 고려하여야 할 TMD 환자를 감별하는데 유용한 정보를 제공할 수 있을 것이다.

• Journal of Gastric Cancer
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• 제24권3호
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• pp.316-326
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• 2024

Purpose: This study was performed to assess the lifestyle-related behaviors of patients with gastric cancer (GC) and to investigate the associations between the time since GC diagnosis and these behaviors. Materials and Methods: This study included 29,478 adults (including 338 patients with GC) aged ≥ 40 years who participated in the Korea National Health and Nutrition Examination Survey 2014-2021. Multiple logistic regression analysis explored the associations between the time since GC diagnosis (patients diagnosed with GC less than 5 years ago [<5 years group] and those diagnosed with GC 5 or more than years ago [≥5 years group]) and lifestyle factors. Subgroup analyses were conducted based on age and sex. Results: The current smoking rate was not lower in the GC group than in the healthy group, regardless of time since diagnosis. Compared to the healthy controls, monthly alcohol intake was lower in the <5 years group (odds ratio [OR], 0.450; 95% confidence interval [CI], 0.275-0.736). The ≥5 years group showed a lower rate of strength training (OR, 0.548; CI, 0.359-0.838), compared with the healthy control group. Subgroup analysis focusing on the ≥5 years group revealed a significantly lower rate of strength training, particularly in patients aged ≥65 years and male patients (OR, 0.519 and 0.553; CI, 0.302-0.890 and 0.340-0.901, respectively). Conclusions: Clinicians should continue educating patients on lifestyle behavior modifications, particularly alcohol abstinence, even beyond 5 years after GC diagnosis. Education on strength training is especially important for patients ≥65 years or male patients.

• 동의신경정신과학회지
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• 제23권4호
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• pp.107-122
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• 2012

Objectives : The purpose of this study is to examine the general personality profiles of patients who visited an oriental neuropsychiatric clinic and to investigate the specific profiles of patients diagnosed with Hwa-byung. Methods : We analyzed the profiles of 122 patients who completed TCI-RS questionnaire for the purpose of counseling. Patients were divided by sex, age and diagnosis related groups. Scales and subscales of each group were compared by an independent t-test and ANCOVA with SPSS windows 16.0. Types of temperament and character were classified by percentile ranks of the total patients and diagnosis related groups. Results : 1. Total patients were classified as the high harm avoidance type of temperament and of low self-directedness type of character. 2. Male patients showed significantly higher scores on NS, all subscales of NS, P2 and P3 than female patients. HA4 and C5 scores were significantly higher in the female group. Younger patients showed significantly higher scores on NS, all subscales of NS, HA1 and P3. However, older patients had significantly higher scores on SD4, SD5, ST2 and ST3. 3. Between diagnosis related groups, Hwa-byung group had significantly higher scores on RD, ST, SD3 and ST2. However P3 score of non-hwa-byung patients was higher than hwa-byung patients. In typical classification, both hwa-byung and non-hwa-byung groups were classified as the same types as total patients. Conclusions : This study showed that the patients visited an oriental neuropsychiatric clinic and had similar personality with that of general psychiatric disorders. Hwa-byung patients exhibited higher RD and ST scores than other disorders, but they had no typical differences.

• 보건행정학회지
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• 제23권4호
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• pp.326-342
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• 2013

Background: Engaging and Involving stakeholders who have different interests in changing health care policies are difficult task. As the literature on the governance in Korean health care field is rare, this study aims to provide empirical evidence of 'governing health policy'-the ways health care policy is made, implemented, and evaluated from a political perspective. Methods: The authors of this study conducted interviews with elites in policy and clinical areas, which was considered to be the most effective approach to gather in-depth information about the background of changing payment policy as well as the barriers or contributors for making the policy sustainable. A total of 14 experts (3 government officials, 2 representatives from medical profession, 3 professors form academic field, and 6 healthcare providers from New DRG pilot program hospitals) participated in 2 hour long interviews. Results: There was a perception gap of the feasibility and substantiality of new payment system among elites. The score was higher in government officers than those in scholars or clinical experts. Next, the interviewees indicated that Korean New DRG might not sustain without significant efforts to improving democratic aspects of the governance. It is also notable that all interviewees except healthcare providers provided negative expectation of the contribution of new payment system to increase administration efficiency. For clinical efficiency, every stakeholders perceived there was no increased efficiency after introduction of New DRG payment. Like general perception, there was a wide gap between the perception of stakeholders in quality change after implementing the new payment system. Finally, interview participants negatively assumed about the likelihood of New DRG to remain a case of successful reforms. Conclusion: This study implied the importance of social consensus and the governance of health policy.

• 한국의료질향상학회지
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• 제27권2호
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• pp.30-44
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• 2021

Purpose: The aim of this study was to investigate the changes in perception of the New Diagnosis-Related Group (DRG)-based payment system, make overall evaluation after participation, and examine opinions on further policy improvement among employees of a public hospital participating in the pilot project in Korea. Methods: We investigated changes in perception of the New DRG-based payment system before and after participation in the pilot project using a qualitative research method. We conducted individual in-depth interviews with the management and healthcare professionals and Focus Group Interviews (FGIs) with the staff in the nursing and administrative departments. Results: Before implementing the pilot project of the New DRG-based payment system, the management was in favor of participating in the pilot project, whereas the healthcare professionals were strongly opposed to participation in the pilot project, and the staff in the nursing and administrative departments were slightly opposed to participation. After implementing the pilot project, there were remarkable changes in the perception of the New DRG-based payment system among healthcare professionals and the administrative staff. Healthcare professionals' perception was altered in a positive way, while the administrative staff's perception of the system became negative. Conclusion: There were no restrictions on clinical practice or deterioration of quality of care observed in association with the participation in the New DRG-based payment system. However, certain unintended consequences of the New DRG-based payment system may arise as well. Therefore, the government needs to examine the problems identified in this study to reflect on and improve the New DRG-based payment system for stable expansion.

• 대한한방부인과학회지
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• 제24권3호
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• pp.146-155
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• 2011

Objectives: Since early developed measurement of Postpartum depression(PPD) doesn't reflect physical symptoms, we need to find out how PPD and related physical disorders are expressed in functional medical methods. The study was conducted to find out characteristics of 7 Zone diagnosis and postpartum physical symptoms on PPD. Methods: To 216 postpartum women who did normal delivery, we measured 7-zone-diagnosis Factor AA's height on 5th day and 15th day postpartum. And we surveyed EPDS and postpartum physical symptoms question on 15th day postpartum. Subjects were divided into normal and depression group by EPDS score. And we compared Factor AA's height between two groups and Factor AA's height change in each group. Results: In depression group, Factor AA's height was higher than normal group on 5th day and 15th day postpartum. In both groups Factor AA's height was decreased on 15th day compared to 5th day postpartum. In normal group 2, 6, 7 zone were significantly decreased and in depression group only 6 zone was significantly decreased. Conclusions: These results demonstrate that postpartum depression group has low recuperative power. And these can be judged by Factor AA's height change.

• Hip & pelvis
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• 제34권4호
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• pp.236-244
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• 2022

Purpose: The most recent diagnostic criteria for periprosthetic joint infection (PJI) include the use of the alpha-defensin (AD) lateral-flow (LF) test, but hip and knee arthroplasties were usually combined in previous studies. This prospective study was designed to examine the accuracy of the AD-LF test for diagnosis of PJI in chronic painful total hip arthroplasties (THA). Materials and Methods: Patients with chronic painful hip arthroplasties were prospectively enrolled between March 2018 and May 2020. Exclusion criteria included acute PJI or an insufficient amount of synovial fluid. The modified Musculoskeletal Infection Society (MSIS) criteria were primarily used for PJI diagnosis. Fifty-seven patients were included in the analysis group. Revision surgery was not performed in 38 patients, for different reasons (clinical group); these patients remain "Schrödinger's hips": in such cases PJI cannot be excluded nor confirmed until you "open the box". Results: The result of the AD-LF test was positive in nine patients and negative in 48 patients. Six patients were diagnosed with PJI. AD-LF sensitivity (MSIS criteria) was 83% (95% confidence interval [CI] 36-100%) and specificity was 92% (95% CI 81-98%). The positive and negative predictive value were 56% and 98%, respectively. Conclusion: The AD test is useful in addition to the existing arsenal of diagnostic tools, and can be helpful in the decision-making process. Not all patients with chronical painful THA will undergo revision surgery. Consequently, in order to determine the reliable diagnostic accuracy of this test, future PJI diagnostic studies should include a second arm of "Schrödinger's hips".